'Navigators' help Kansans enroll in health plans

9/16/2013

WICHITA (AP) — The "navigators" who will help Kansans enroll in health plans as the new insurance marketplaces prepare to go live are training for the role, but still don't know details of the plans, rates or subsidies.

WICHITA (AP) — The "navigators" who will help Kansans enroll in health plans as the new insurance marketplaces prepare to go live are training for the role, but still don't know details of the plans, rates or subsidies.

The Kansas Association for the Medically Underserved held a training conference for about 40 navigators this week in Wichita, so they could learn about the Affordable Care Act and what to expect once the marketplace opens on Oct. 1.

The Wichita Eagle reports that plans vary by state, but Kansas and most others still have not released information about the cost of plans that will be offered.

Enrollment will take place online at www.HealthCare.gov, but the site has not yet gone live.

"Visually we don't know," said Nick Clasen, a patient care coordinator and navigator-in-training for the Center for Health and Wellness.

"But I do think we all have a pretty good idea of the process," he added. "It's going to be sit down, explain things, help them apply, check eligibility and then it's about giving them all the information about each option — not guiding them to an option — but making sure the person can make an autonomous decision."

The navigators will have about 20 hours of online training through the Centers for Medicare and Medicaid Services and must pass tests to become certified.

"I do feel prepared on assisting people with it; it's just not knowing what it's going to look like is challenging," said Juven Nava, GraceMed outreach coordinator and navigator-in-training.

Navigators, unlike a typical insurance broker, are not supposed to recommend one plan over another, said Cathy Harding, KAMU executive director.

"The (website) is going to be designed in a way that shows comparisons," Harding said. "Each of the plans will have different levels — bronze, silver, gold, platinum — side by side, apples to apples, to show what each of those plans look like."

Although anyone is able to enroll themselves online, the navigators can help, she said.

Because the Affordable Care Act was designed to accompany an expansion of Medicaid, Harding said states like Kansas that turned down federal money to expand Medicaid have a "Medicaid doughnut hole," where some residents will make too much to qualify for Medicaid but not enough to afford insurance available on the marketplace.

"Out of everything the navigators will do, the hardest thing they'll do is to tell somebody they're too poor to benefit from the health insurance marketplace. And in Kansas, Medicaid eligibility is one of the strictest in the country," Harding said. "I think it will be difficult for people to work with someone about their options and look that person in the eye and say, 'I'm sorry, we can't help you.'"

The federal government passed a rule that those in the "hole" won't have to pay penalties if they don't purchase health insurance under the individual mandate. But that still will leave a portion without insurance.

"If you're a childless adult in Kansas and you're not disabled, you don't qualify for Medicaid. Period. Regardless of how much or how little money you make," Harding said.

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